Fautrel B, Le Moël G, Saint-Marcoux B, Taupin P, Vignes S, Rozenberg S, Koeger A C, Meyer O, Guillevin L, Piette J C, Bourgeois P
Department of Rheumatology, Pitié-Salpêtrière Hospital, Paris, France.
J Rheumatol. 2001 Feb;28(2):322-9.
To determine the usefulness of serum ferritin and glycosylated ferritin (GF) levels in diagnosing adult onset Still's disease (AOSD).
We performed a retrospective multicenter study of 205 patients who had ferritin and GF assays in one hospital laboratory. Records of all patients were reviewed, and a standardized questionnaire used to extract all data available at the time of the assay. The clinicians' final diagnosis was also recorded. Patients were classified as having "certain AOSD" (based on Yamaguchi's criteria) or a control disease. The concordance of ferritin and GF levels with final diagnosis was evaluated.
In total 49 AOSD and 120 control patients were eligible. The mean ferritin value was significantly higher in the AOSD group (4,752 +/- 9,599 microg/l) than in the control group (1,571 +/- 3,807 microg/l), p = 0.029. GF was significantly lower in AOSD patients (15.9 +/- 11.9%) than in the control group (31.5 +/- 18.7%), p < 0.001. The combination of a GF level of < or = 20% with ferritin above the upper limit of normal yielded a sensitivity of 70.5% and specificity of 83.2%. The combination of a GF level < or = 20% with ferritin 5 times normal produced a sensitivity of 43.2% and specificity of 92.9%. This latter combination allowed an AOSD diagnosis to be ruled out for 6 of the 8 control patients who met Yamaguchi's positive criteria.
Ferritin and GF levels are powerful diagnostic markers of AOSD. They may be helpful in clinical practice for excluding differential diagnoses.
确定血清铁蛋白和糖化铁蛋白（GF）水平在诊断成人斯蒂尔病（AOSD）中的作用。
我们对在一家医院实验室进行铁蛋白和GF检测的205例患者进行了一项回顾性多中心研究。查阅了所有患者的记录，并使用标准化问卷提取检测时可获得的所有数据。还记录了临床医生的最终诊断。患者被分类为患有“确诊AOSD”（基于山口标准）或对照疾病。评估铁蛋白和GF水平与最终诊断的一致性。
共有49例AOSD患者和120例对照患者符合条件。AOSD组的平均铁蛋白值（4,752±9,599微克/升）显著高于对照组（1,571±3,807微克/升），p = 0.029。AOSD患者的GF显著低于对照组（15.9±11.9%）（31.5±18.7%），p < 0.001。GF水平≤20%且铁蛋白高于正常上限的联合检测敏感性为70.5%，特异性为83.2%。GF水平≤20%且铁蛋白为正常5倍的联合检测敏感性为43.2%，特异性为92.9%。后一种联合检测可排除8例符合山口阳性标准的对照患者中的6例AOSD诊断。
铁蛋白和GF水平是AOSD的有力诊断标志物。它们在临床实践中可能有助于排除鉴别诊断。
